The Vulnerability of Corneal Endothelial Cells to External Forces and Moments

Collaborators: Yousuf Khalifa, M.D., Naveen Mysore, M.D., Ph.D

More than 65,000 vision-restoring corneal transplantations take place every year for individuals with corneal disease, injury (e.g., from cataract surgery) and scarring. The most common reason for transplanted corneal grafts to fail is loss of corneal endothelial cells (CECs), the cells that line the inside of the cornea and pump fluid from it to maintain corneal transparency. Many of these cells are killed during transplantation surgery due to physical manipulation of corneal grafts and contact of the donor endothelium with surrounding tissues, surgical tools, tissue injectors, suture material and/or irrigating fluid. Thus, understanding how susceptible CECs are to mechanically-mediated cell death is of great clinical interest.

Unfortunately, the vulnerability of CECs to controlled, measurable mechanical forces and moments imparted using materials testing equipment – in contrast with surgically-imparted forces that are difficult to control and quantify – has not been assessed. Thus, we are working to characterize the types (e.g., shear, indentation, etc.) and magnitudes of mechanical forces necessary to kill CECs. The findings of this study could inform the development of new tools and/or surgical strategies designed to prevent application of CEC-damaging external forces.